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2. 

3. Please complete this form completely as the information may help in reuniting a pet.

5. Submitter Information

7. First Name*
8. Last Name*
10. Address
12. City
13. State
    -- Select One --ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
14. Zip Code

18. Contact Information

20. Primary Phone*
21. Alternate Phone
23. Email*

27. Pet Owner Information

29. Owner First Name*
30. Owner Last Name*
32. Relationship to Submitter
    -- Select One --SelfSpouseChildParentOther family memberFriend
33. Owner Age?
    -- Select One --0 to 1819 to 3030 to 4545+
35. Owner Address*
37. Owner City*
38. Owner State*
    -- Select One --ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAVIWAWVWIWY
39. Owner Zip Code*
41. Owner Primary Phone*
42. Owner Alternate Phone
44. Owner Email*

48. Last Known Location of Pet

50. Date Pet Went Missing
    Date Pet Went Missing
51. Time Pet Went Missing
    Time Pet Went Missing
53. Address Where Pet Was Last Seen
55. City*
56. State Last Seen
    -- Select One --ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
57. Zip Code Last Seen
59. Major/Closest Crossroads Last Seen*

63. Animal Description

65. Type

    1. Dog
    2. Cat
66. Breed (Cat)
    -- Select One --AbyssinianAmerican Curl (Long Haired)American Curl (Short Haired)American ShorthairAmerican WirehairAngoraBalineseBengalBirmanBombayBritish ShorthairBurmeseChartreuxColorpointCornish RexCymricDevon RexDomestic LonghairDomestic MediumDomestic ShorthairEgyptian MauEuropean ShorthairExotic ShorthairHavana BrownHimalayanJapanese BobtailJavaneseKoratMaine CoonMalayanManxMunchkin LonghairMunchkin ShorthairNorwegian ForestOcicatOriental ShorthairPersianPixiebob LonghairPixiebob ShorthairRagdollRexRussian BlueSavannahScottish FoldSiameseSingapuraSnowshoeSomaliSphynxTiffanyTonkineseTurkish AngoraTurkish Van
67. Breed (Dog)
    -- Select One --AffenpinscherAfghan HoundAiredale TerrierAkbashAlaskan Klee KaiAlaskan MalamuteAlaskan HuskyAmerican BulldogAmerican Pit Bull TerrierAmerican EskimoAmerican FoxhoundAmerican Water SpanielAmerican Staffordshire TerrierAnatolian ShepherdAustralian Cattle DogAustralian KelpieAustralian ShepherdAustralian TerrierBasenjiBasset HoundBeagleBearded CollieBeauceronBedlington TerrierBelgian LakenoisBelgian MalinoisBelgian SheepdogBelgian TervurenBernese HoundBernese Mountain DogBichon FriseBlack Mouth CurBlack and Tan HoundBloodhoundBlue LacyBluetick HoundBoerboelBorder CollieBorzoiBoston TerrierBouvier des FlandresBoxerBoykin SpanielBriardBrittanyBrussels GriffonBull TerrierBull Terrier MiniatureBulldogBullmastiffCairn TerrierCanaan DogCane CorsoCarolina DogCatahoulaCavalier SpanielChesapeake Bay RetrieverChihuahua (Long Hair)Chihuahua (Short Hair)Chinese Crested DogChinese Shar-PeiChow ChowCirneco dell'EtnaClumber SpanielCocker SpanielCollie (Rough)Collie (Smooth)Coton de TulearCoyote HybridCurly-coated RetrieverDachshund (Longhaired)Dachshund (Smooth)Dachshund (Wirehaired)DalmationDandie DinmontDoberman PinscherDogo ArgentinoDogue de BordeuxDutch SheepdogDutch ShepherdEnglish BulldogEnglish Cocker SpanielEnglish CoonhoundEnglish FoxhoundEnglish PointerEnglish SetterEnglish ShepherdEnglish Springer SpanielEnglish Toy SpanielEntlebucher Mountain DogEurasierFeistField SpanielFila BrasileiroFinnish SpitzFlat Coat RetrieverFox Terrier (Smooth)Fox Terrier (Wirehaired)French BulldogGrand Basset Griffon VendéenGerman Shorthaired PointerGerman ShepherdGerman Wirehaired PointerGerman PinscherGlen of Imaal TerrierGolden RetrieverGordon SetterGreater Swiss Mountain DogGreat DaneGreat PyreneesGreyhoundHarrierHavaneseHovawartIbizan HoundIrish SetterIrish TerrierIrish Water SpanielIrish WolfhoundItalian GreyhoundJapanese ChinJindoKangalKarelian Bear DogKeeshondKerry Blue TerrierKomondorKuvaszLabrador RetrieverLakeland TerrierLandseerLeonbergerLhasa ApsoLowchenMalteseManchester TerrierMaremmano-Abruzzese SheepdogMastiffMexican HairlessMiniature PinscherMunsterlanderNeapolitan MastiffNewfoundlandNorfolk TerrierNorwegian BuhundNorwegian ElkhoundNorwich TerrierNova Scotia Duck Tolling RetrieverOld English BulldogOld English SheepdogOtterhoundPapillonParson Russel TerrierPatterdale TerrierPetit Basset Griffon VendéenPekingesePharaoh HoundPicardy SheepdogPlott HoundPointerPolish LowlandPomeranianPoodle (Miniature)Poodle (Standard)Poodle (Toy)Portuguese PodengoPortuguese Water DogPresa CanarioPugPuliPumiQueensland HeelerRat TerrierRedbone CoonhoundRhodesian RidgebackRottweilerSalukiSamoyedSoft-coated Wheaten TerrierSchipperkeSchnauzer (Giant)Schnauzer (Miniature)Schnauzer (Standard)Scottish DeerhoundScottish TerrierSealyham TerrierShetland SheepdogShiba InuShih TzuSiberian HuskySilky TerrierSkye TerrierSpanish Water DogSpanish MastiffSpinone ItalianoSt Bernard (Rough Coat)St Bernard (Smooth Coat)Staffordshire Bull TerrierSussex SpanielSwedish VallhundSwiss HoundTibetan MastiffTibetan SpanielTibetan TerrierTosaToy Fox TerrierTreeing Tennessee BrindleTreeing Walker HoundTreeing CurVizslaVizsla WirehairedWeimaranerWelsh Corgi CardiganWelsh Corgi PembrokeWelsh Springer SpanielWelsh TerrierWest Highland White TerrierWirehaired Pointing GriffonWhippetWolf HybridYorkshire Terrier
69. Sex
    -- Select One --Male - UnalteredMale - NeuteredFemale - UnalteredFemale - Spayed
70. Animal Size
    -- Select One --Puppy/KittenSmallMediumLarge
71. Color of Coat
    -- Select One --BlackBrownGreyWhiteBlack/BrownBlack/WhiteBrown/WhiteGrey/BlackGrey/BrownGrey/WhiteOther
73. Pet's Birth Date
    Pet's Birth Date
74. Approximate Age of Pet
75. Pet's Name
77. Other Color
79. Ear Shape
    -- Select One --CroppedDroopyErectRoseSemi-erect
80. Tail
    -- Select One --BobtailCurly BushyCurly SmoothLongLong BushyLong FeatherLong SmoothLong WiryMediumShortShort SmoothNo Tail
81. Nose
    -- Select One --Long SnoutShort SnoutFlat
83. Was the pet wearing a collar?

    1. Yes
    2. No
84. Collar information?

    Please describe the collar and any additional information on it.

86. Description of animal

    Please provide as much detail as possible, include any unique markings.

88. Microchipped?

    1. Yes
    2. No
89. Microchip #
90. Did you contact the microchip company?

    1. Yes
    2. No
92. Additional Information

    Please provide anything else that may be helpful in finding and identifying the pet.

94. Important information

    Please upload images in .jpg, .jpeg, or .gif images.

96. Pet Photo

    To help get a lost pet home, take the time to make sure the pet is the star of the photo. The best photos include the animal’s face and side of the body so that any distinguishing markings can be seen. 

98. When the submit button is clicked, your lost pet report will be submitted. You may be contacted via text and/or email for additional information.

Leave This Blank:


100. 1. Receive an email copy of this form.
101. Email address

     This field is not part of the form submission.

102. Submit

* indicates a required field